Outcomes of simultaneous endoscopic submucosal dissection for synchronous multiple gastric neoplastic lesions: a retrospective comparative study

Xu, Shanshan; Chai, Ningli; Tang, Xiaowei; Linghu, Enqiang; Zhang, Lu; Wang, Shasha; Li, Bao

doi:10.1007/s00464-021-08722-5

Cited by 2 publications

(3 citation statements)

References 35 publications

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“…Additionally, the postoperative adverse events were significantly less in the ESD group than in the gastrectomy group. However, during the follow-up period, we found that the recurrence rates were higher in the ESD group, which is similar to the latest study by Xu et al [ 9 ]. One probable explanation is that recurrence was detected during the patients’ postoperative gastroscopy, and timely surgical resection after diagnosis was performed [ 21 ].As shown in Fig.…”

Section: Discussionsupporting

confidence: 91%

“…Kasuga et al and Joh et al reported that ESD is a feasible and effective option for the treatment of synchronous early gastric carcinoma [ 5 , 26 ]. However, previous studies have shown that with ESD in the treatment of multifocal gastric cancer, there will be a high recurrence rate of tumors, as well as minor lesions missed with endoscopy [ 9 , 27 ]. Therefore, Morgagni et al found that subtotal gastrectomy could be considered a sufficient treatment when gastroscopy determines that the lesions of multifocal gastric cancer are limited to the lower third [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…But it is not clear whether multifocal early gastric cancer applies to this standard. Most current studies focus on the comparison of prognosis between multifocal gastric cancer and unifocal gastric cancer under ESD treatment [ 5 , 9 ].In this research, we aimed to compare the clinical outcomes and prognosis of ESD and gastrectomy in patients with SMEGC in patients, and compare the advantages and disadvantages of the formal anatomic resection versus ESD.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of clinical outcomes and prognosis between surgery and endoscopic submucosal dissection in patients with synchronous multifocal early gastric cancer

Bao,

Gao,

et al. 2023

BMC Surg

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Background Synchronous multiple early gastric cancer (SMEGC) refers to the simultaneous occurrence of two or more malignant cancer lesions in the stomach. For patients with multiple early gastric carcinomas, the choice of appropriate treatment remains controversial. This study is dedicated to comparing the clinical outcomes and prognosis of patients with SMEGC who underwent endoscopic submucosal dissection (ESD) or gastrectomy. Methods A total of 180 patients with more than one malignant cancer lesion in the stomach who had received gastrectomy or ESD between 2012 and 2021 were retrospectively evaluated to determine their clinical outcomes and prognosis. Univariate and multivariate logistic regression were utilized to identify risk factors for tumor recurrence. Results Over the 57.5 months median follow-up period for the 140 enrolled cases, tumor recurrence occurred in 8 (12%) in the ESD group but only 1 (1%) in the surgery group. Relapse-free survival (RFS) was higher in the surgery group (p = 0.023) in all cases; however, there was no significant difference in Overall survival (OS, p = 0.772). Complications were significantly higher in the surgery group than in the ESD group, but fewer in the radical distal gastrectomy group. Multivariate regression analysis revealed that ESD(p = 0.034), the main lesion size > 2 cm(p = 0.019), and undifferentiated tumor(p = 0.022) were independent risk factors for tumor recurrence. Conclusions For the treatment of simultaneous multifocal early gastric cancer, ESD has a good short-term effect and higher quality of life. However, ESD has a higher risk of recurrence than surgery. And we found that the partial gastrectomy appears to be considered as adequate treatment for some SMEGC patients.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of clinical outcomes and prognosis between surgery and endoscopic submucosal dissection in patients with synchronous multifocal early gastric cancer

Bao,

Gao,

et al. 2023

BMC Surg

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Endoscopic Features of Synchronous Multiple Early Gastric Cancers: Findings from a Nationwide Cohort

Hayashi,

Hatta,

Tsuji

et al. 2024

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Introduction: We investigated the factors associated with synchronous multiple early gastric cancers and determined their localization. Methods: We analyzed 8191 patients who underwent endoscopic submucosal dissection for early gastric cancers at 33 hospitals in Japan from November 2013 to October 2016. Background factors were compared between single-lesion (n=7221) and synchronous multi-lesion cases (n=970) using univariate and multivariate analyses. We extracted cases with two synchronous lesions (n=832) and evaluated their localization. Results: Significant independent risk factors for synchronous multiple early gastric cancer were older age (≥75 years old) (OR=1.257), male sex (OR=1.385), severe mucosal atrophy (OR=1.400), tumor localization in the middle (OR=1.362) or lower region (OR=1.404), and submucosal invasion (OR=1.528 (SM1), 1.488 (SM2)). Depressed macroscopic type (OR=0.679) and pure undifferentiated histology OR=0.334) were more common in single early gastric cancers. When one lesion was in the upper region, the other was more frequently located in the lesser curvature of the middle region. When one lesion was in the middle region, the other was more frequently located in the middle region or the lesser curvature of the lower region. When one lesion was in the lower region, the other was more frequently located in the lesser curvature of the middle region or the lower region. Conclusion: Factors associated with synchronous multiple early gastric cancer included older age, male sex, severe mucosal atrophy, tumor localization in the middle or lower region, and tumor submucosal invasion. Our findings provide useful information regarding specific areas that should be examined carefully when one lesion is detected.

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Outcomes of simultaneous endoscopic submucosal dissection for synchronous multiple gastric neoplastic lesions: a retrospective comparative study

Cited by 2 publications

References 35 publications

Comparison of clinical outcomes and prognosis between surgery and endoscopic submucosal dissection in patients with synchronous multifocal early gastric cancer

Comparison of clinical outcomes and prognosis between surgery and endoscopic submucosal dissection in patients with synchronous multifocal early gastric cancer

Endoscopic Features of Synchronous Multiple Early Gastric Cancers: Findings from a Nationwide Cohort

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